Physician offers life-changing surgery for rare esophageal condition
If you enjoy eating, achalasia is not something you ever want to develop. This rare disease of the esophagus – the swallowing tube – means "failure to relax." It refers to the inability of the lower esophageal muscle to open and allow food to pass into the stomach.
"As a result of achalasia, patients can't eat and often even have a tough time swallowing liquids as well," explains Thomas Derrig, MD, a general and vascular surgeon who sees patients at the Aurora Wilkinson Medical Clinic in Oconomowoc and Hartland. "Patients typically lose a profound amount of weight."
Fortunately, a proven surgery called Heller Cardiomyotomy can completely reverse the situation in almost every patient with the diagnosis. Most physicians perform the operation as an open procedure. Dr. Derrig, however, is one of few doctors in the area who also offers it laparoscopically that is, with micro-size surgical instruments and a camera inserted through tiny incisions in the abdomen.
When Peter Hafemeister, a 59-year-old farm machine salesman from Juneau, came to see Dr. Derrig, he had already lost 27 pounds as a result of achalasia.
"I started having problems in May," Peter recalls. "When I'd go to bed at night, I'd wake up gagging from the material coming up into my throat. I went to my primary care doctor and began being treated for acid reflux. But after three months on the 'purple pill' with no improvement, he referred me to a GI specialist."
By that time, Peter says he was forced to sleep sitting straight up in a chair all night, every night. The symptoms also had progressed to the point where he could no longer eat normal meals, and going out to dinner was a thing of the past.
"I had to eat really slow and really small portions to try to keep the food down," he explains. "It was even hard to drink water or have a sip of soda without it coming right back up. The doctors told me it would help not to eat anything after 7 each night, but in reality, I couldn't eat anything all day."
After extensive testing with Nimish Vakil, MD, a gastroenterology specialist at the Aurora Health Center in Waukesha, Peter was diagnosed with achalasia and referred to Dr. Derrig for surgery.
"Heller Cardiomytomy is a lifestyle-changing surgery in the sense that people go into it not being able to eat, and come out of it able to resume a normal diet without any restrictions," says Dr. Derrig. "It's an exciting operation to do because it makes a night and day difference for patients. With all of my patients, the surgery has been 100 percent effective."
While the Heller Cardiomyotomy is an established operation, what sets Dr. Derrig apart is his expertise in the laparoscopic technique. He was the first in western Waukesha to offer the minimally-invasive version of the procedure five years ago, and for patients, the difference is a 23-hour hospitalization instead of four or five days, and five one-centimeter incisions that don't even need deep stitches, versus a long midline incision from belly button to breast bone during open surgery.
Following the laparoscopic procedure, patients quickly return to normal activity. Peter, in fact, was back at work within two days.
"It was amazing," says Peter. "I had practically no pain from the surgery, and I was able to start eating normally again right away. I had the surgery at 9:30 in the morning, and at noon, I was drinking a chocolate malt. Later that day, I had mashed potatoes and gravy, and then some chicken soup."
Peter reports that he's "been eating and sleeping well ever since."
"My life is finally back to normal again," he says.
If you have persistent worsening problems with swallowing, make sure you let your physician know, as you might be developing a problem that could require surgical attention. To better understand your personal health risks and what you can do to improve your health, talk to your primary care physician. To schedule an appointment with Dr. Derrig, call the Aurora Wilkinson Medical Clinic in Oconomowoc at 262-569-2300, or in Hartland at 262-369-7040.